Organization Active NPI

Northside Chiropractic Center

  • Chiropractor
  • Kings Park, NY
National Provider Identifier
1033398722
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NORTHSIDE CHIROPRACTIC CENTER
Practice address
185 Main St
Kings Park, NY 11754-2607
Phone
(631) 544-0770
NPI assigned
Oct 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessica R Grandal
Title
Partner
Phone
(631) 544-0770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

185 Main St
Kings Park, NY 11754-2607

Mailing address

185 Main St
Kings Park, NY 11754-2607
Phone (631) 544-0770

National Provider Directory

National Provider Directory

Locations

185 Main St
Kings Park, NY 11754
Phone (631) 544-0720

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1033398722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 MAIN ST",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542607",
            "telephone_number": "631-544-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 MAIN ST",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117542607",
            "telephone_number": "631-544-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "GRANDAL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "631-544-0770"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.